The utility of the Bethesda category and its association with BRAF mutation in the prediction of papillary thyroid cancer stage

Augustas Beiša, Mindaugas Kvietkauskas, Virgilijus Beiša, Mindaugas Stoškus, Elvyra Ostanevičiūtė, Eugenijus Jasiunas, Laimonas Griškevičius, Kęstutis Strupas

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Abstract

Purpose This study aims to determine the utility of the Bethesda category and its association with BRAF mutation in prediction of the papillary thyroid cancer (PTC) stage. Methods A prospective study analyzed patients who had ultrasound-suspicious thyroid nodules, underwent FNA and cytological examination, and were classified according to the Bethesda system. Patients from Undetermined Significance Or Follicular Lesion Of Undetermined Significance (AUS/ FLUS), Follicular Neoplasm or Suspicious for a Follicular Neoplasm (FN/SFN), Suspicious for Malignant Cells (SMC), and Positive for Malignant Cells (PMC) groups were examined for the BRAF mutation and had a thyroid surgery. Demographical and histological features and stage of the disease were evaluated for PTC patients in accordance with the Bethesda category and its association with BRAF mutation. Results Three hundred eight of all patients underwent operation. One hundred forty-three (46.4%) of them were diagnosed with PTC. In 14 (9.8%) PTC cases, FNA biopsies were classified as AUS/FLUS, 23 (16.1%) as FN/SFN, 41 (28.7%) as SMC, and 65 (45.5%) as PMC. I–II stages of PTC were diagnosed for 88 (61.5%) patients and III–IVA for 55 (38.5%). Patients from the SMC and PMC groups had larger tumors, higher incidence of lymph node metastases, classical PTC type, B-type Raf (BRAF) positive, and III–IVA stage cancer, than patients from the AUS/FLUS and FN/SFN groups. When comparing 27 (18.9%) BRAF-negative patients from the AUS/FLUS and FN/SFN groups with 116 (81.1%) BRAFnegative patients from the SMC and PMC groups and all BRAF-positive patients, the prediction of more aggressive histological features and stage was slightly improved. Conclusions Higher Bethesda categories are associated with higher stages of PTC. Association of the Bethesda category with BRAF mutation can slightly improve the value of stage prediction.
Original languageEnglish
Pages (from-to) 227-2348
Number of pages2122
JournalLangenbeck's Archives of Surgery
Volume402
Issue number2
DOIs
Publication statusPublished - 2017

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Mutation
Neoplasms
Papillary Thyroid cancer
Thyroid Nodule
Thyroid Gland
Lymph Nodes
Prospective Studies
Neoplasm Metastasis
Biopsy
Incidence

Keywords

  • Bethesda system
  • BRAF mutation
  • Fine-needle aspiration
  • Papillary thyroid cancer
  • Thyroid

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The utility of the Bethesda category and its association with BRAF mutation in the prediction of papillary thyroid cancer stage. / Beiša, Augustas ; Kvietkauskas, Mindaugas ; Beiša, Virgilijus ; Stoškus, Mindaugas ; Ostanevičiūtė, Elvyra ; Jasiunas, Eugenijus ; Griškevičius, Laimonas ; Strupas, Kęstutis .

In: Langenbeck's Archives of Surgery, Vol. 402, No. 2, 2017, p. 227-2348.

Research output: Contribution to journalArticle

Beiša, A, Kvietkauskas, M, Beiša, V, Stoškus, M, Ostanevičiūtė, E, Jasiunas, E, Griškevičius, L & Strupas, K 2017, 'The utility of the Bethesda category and its association with BRAF mutation in the prediction of papillary thyroid cancer stage', Langenbeck's Archives of Surgery, vol. 402, no. 2, pp. 227-2348. https://doi.org/10.1007/s00423-017-1560-2
Beiša, Augustas ; Kvietkauskas, Mindaugas ; Beiša, Virgilijus ; Stoškus, Mindaugas ; Ostanevičiūtė, Elvyra ; Jasiunas, Eugenijus ; Griškevičius, Laimonas ; Strupas, Kęstutis . / The utility of the Bethesda category and its association with BRAF mutation in the prediction of papillary thyroid cancer stage. In: Langenbeck's Archives of Surgery. 2017 ; Vol. 402, No. 2. pp. 227-2348.
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title = "The utility of the Bethesda category and its association with BRAF mutation in the prediction of papillary thyroid cancer stage",
abstract = "Purpose This study aims to determine the utility of the Bethesda category and its association with BRAF mutation in prediction of the papillary thyroid cancer (PTC) stage. Methods A prospective study analyzed patients who had ultrasound-suspicious thyroid nodules, underwent FNA and cytological examination, and were classified according to the Bethesda system. Patients from Undetermined Significance Or Follicular Lesion Of Undetermined Significance (AUS/ FLUS), Follicular Neoplasm or Suspicious for a Follicular Neoplasm (FN/SFN), Suspicious for Malignant Cells (SMC), and Positive for Malignant Cells (PMC) groups were examined for the BRAF mutation and had a thyroid surgery. Demographical and histological features and stage of the disease were evaluated for PTC patients in accordance with the Bethesda category and its association with BRAF mutation. Results Three hundred eight of all patients underwent operation. One hundred forty-three (46.4{\%}) of them were diagnosed with PTC. In 14 (9.8{\%}) PTC cases, FNA biopsies were classified as AUS/FLUS, 23 (16.1{\%}) as FN/SFN, 41 (28.7{\%}) as SMC, and 65 (45.5{\%}) as PMC. I–II stages of PTC were diagnosed for 88 (61.5{\%}) patients and III–IVA for 55 (38.5{\%}). Patients from the SMC and PMC groups had larger tumors, higher incidence of lymph node metastases, classical PTC type, B-type Raf (BRAF) positive, and III–IVA stage cancer, than patients from the AUS/FLUS and FN/SFN groups. When comparing 27 (18.9{\%}) BRAF-negative patients from the AUS/FLUS and FN/SFN groups with 116 (81.1{\%}) BRAFnegative patients from the SMC and PMC groups and all BRAF-positive patients, the prediction of more aggressive histological features and stage was slightly improved. Conclusions Higher Bethesda categories are associated with higher stages of PTC. Association of the Bethesda category with BRAF mutation can slightly improve the value of stage prediction.",
keywords = "Bethesda system, BRAF mutation , Fine-needle aspiration, Papillary thyroid cancer, Thyroid",
author = "Augustas Beiša and Mindaugas Kvietkauskas and Virgilijus Beiša and Mindaugas Stoškus and Elvyra Ostanevičiūtė and Eugenijus Jasiunas and Laimonas Griškevičius and Kęstutis Strupas",
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TY - JOUR

T1 - The utility of the Bethesda category and its association with BRAF mutation in the prediction of papillary thyroid cancer stage

AU - Beiša, Augustas

AU - Kvietkauskas, Mindaugas

AU - Beiša, Virgilijus

AU - Stoškus, Mindaugas

AU - Ostanevičiūtė, Elvyra

AU - Jasiunas, Eugenijus

AU - Griškevičius, Laimonas

AU - Strupas, Kęstutis

PY - 2017

Y1 - 2017

N2 - Purpose This study aims to determine the utility of the Bethesda category and its association with BRAF mutation in prediction of the papillary thyroid cancer (PTC) stage. Methods A prospective study analyzed patients who had ultrasound-suspicious thyroid nodules, underwent FNA and cytological examination, and were classified according to the Bethesda system. Patients from Undetermined Significance Or Follicular Lesion Of Undetermined Significance (AUS/ FLUS), Follicular Neoplasm or Suspicious for a Follicular Neoplasm (FN/SFN), Suspicious for Malignant Cells (SMC), and Positive for Malignant Cells (PMC) groups were examined for the BRAF mutation and had a thyroid surgery. Demographical and histological features and stage of the disease were evaluated for PTC patients in accordance with the Bethesda category and its association with BRAF mutation. Results Three hundred eight of all patients underwent operation. One hundred forty-three (46.4%) of them were diagnosed with PTC. In 14 (9.8%) PTC cases, FNA biopsies were classified as AUS/FLUS, 23 (16.1%) as FN/SFN, 41 (28.7%) as SMC, and 65 (45.5%) as PMC. I–II stages of PTC were diagnosed for 88 (61.5%) patients and III–IVA for 55 (38.5%). Patients from the SMC and PMC groups had larger tumors, higher incidence of lymph node metastases, classical PTC type, B-type Raf (BRAF) positive, and III–IVA stage cancer, than patients from the AUS/FLUS and FN/SFN groups. When comparing 27 (18.9%) BRAF-negative patients from the AUS/FLUS and FN/SFN groups with 116 (81.1%) BRAFnegative patients from the SMC and PMC groups and all BRAF-positive patients, the prediction of more aggressive histological features and stage was slightly improved. Conclusions Higher Bethesda categories are associated with higher stages of PTC. Association of the Bethesda category with BRAF mutation can slightly improve the value of stage prediction.

AB - Purpose This study aims to determine the utility of the Bethesda category and its association with BRAF mutation in prediction of the papillary thyroid cancer (PTC) stage. Methods A prospective study analyzed patients who had ultrasound-suspicious thyroid nodules, underwent FNA and cytological examination, and were classified according to the Bethesda system. Patients from Undetermined Significance Or Follicular Lesion Of Undetermined Significance (AUS/ FLUS), Follicular Neoplasm or Suspicious for a Follicular Neoplasm (FN/SFN), Suspicious for Malignant Cells (SMC), and Positive for Malignant Cells (PMC) groups were examined for the BRAF mutation and had a thyroid surgery. Demographical and histological features and stage of the disease were evaluated for PTC patients in accordance with the Bethesda category and its association with BRAF mutation. Results Three hundred eight of all patients underwent operation. One hundred forty-three (46.4%) of them were diagnosed with PTC. In 14 (9.8%) PTC cases, FNA biopsies were classified as AUS/FLUS, 23 (16.1%) as FN/SFN, 41 (28.7%) as SMC, and 65 (45.5%) as PMC. I–II stages of PTC were diagnosed for 88 (61.5%) patients and III–IVA for 55 (38.5%). Patients from the SMC and PMC groups had larger tumors, higher incidence of lymph node metastases, classical PTC type, B-type Raf (BRAF) positive, and III–IVA stage cancer, than patients from the AUS/FLUS and FN/SFN groups. When comparing 27 (18.9%) BRAF-negative patients from the AUS/FLUS and FN/SFN groups with 116 (81.1%) BRAFnegative patients from the SMC and PMC groups and all BRAF-positive patients, the prediction of more aggressive histological features and stage was slightly improved. Conclusions Higher Bethesda categories are associated with higher stages of PTC. Association of the Bethesda category with BRAF mutation can slightly improve the value of stage prediction.

KW - Bethesda system

KW - BRAF mutation

KW - Fine-needle aspiration

KW - Papillary thyroid cancer

KW - Thyroid

U2 - 10.1007/s00423-017-1560-2

DO - 10.1007/s00423-017-1560-2

M3 - Article

VL - 402

SP - 227

EP - 2348

JO - Deutsche Zeitschrift für Chirurgie

JF - Deutsche Zeitschrift für Chirurgie

SN - 1435-2443

IS - 2

ER -